Brief Answer:
Symptom consolidation

Detailed Answer:
Good afternoon. I'm very sorry you're feeling this way and can imagine your frustration. I too am an athlete in the sport of wrestling and both assistant coach as well as still compete in tournaments. Because I'm 57 years old my training is continuous and to my way of thinking...a bit more rugged than the younger guys only because I have no OFF season and in order to stay moving and working with just to practice let alone compete...I have to be burning at twice the clip they need to....and of course, weight is not easy to maintain at my age.....So FATIGUE the way you're describing is very familiar to me. Soreness as well but luckily I think I was born with pretty resilient joints, tendons, and ligaments because I do not suffer from any real deterioration or overuse of them....I also play racquetball quite frequently which I believe keeps me limber in many respects. I don't know if relating what I do for myself would be of any value since we train in different sports....but as a neurologist let me take a crack at giving you at least a couple of ideas you may wanna try "running with"....no pun intended.

If we boil down what seems to be the problem and just from what you've said I would put your list of symptoms as the following:

When you say "lift my leg" I'm assuming you're talking about flexing your hip and elevating the knee up in the flexed position as well, correct? Or are you talking about extending your leg straight in front of you at 90 degree elevation and parallel to the floor....(i.e. core strengthening when we do the elbow rest machine and then, hip flex with both legs going parallel)? That's a hard one for sure...hate doing those...but it's a great core workout.

You you've noticed some type of:

1. alteration in your ability to smell and/or taste since the 2 go together like Frik and Frak.
2. difficulty with holding the leg up at 90 degrees in one form or the other,
3. Quads are painful/uncomfortable/weak?
4. Tachycardia in the mornings
5. Fatigue
6. Depression (you mean "sadness over what's going on....based on everything you're doing I don't see right away a good set of indicators that could put you in a CLINICALLY DEPRESSED CATEGORY....but we'll just accept that for a moment).


So, the idea of you being PHYSICALLY WEAK (from a purely mechanical point of view) is not likely simply based upon the sheer amount of physical activity and weight loads that you're pushing. Being fatigue'ed is a different sort of problem than being physically weak....do you agree?

Tachycardia ONLY in the mornings also is not likely to be some sort of cardiovascular or even cardiac problem since if anything....things would be typically expected to go from good upon awakening and get progressively worse and worse as the day progressed the longer you remained either on your feet or active. But it seems that's NOT the case.

As a neurologist I would be most interested in looking at things such as muscle enzymes and just doing a very complete functional capacities set of tests to see if you have any PATTERNS of weakness or abnormalities. You mention problems in the thigh areas as opposed to the distant leg, ankle, or foot....so there are some pathologies that affect PROXIMAL parts of the body rather than distal.....but generally that sort of problem also includes the upper extremities and you haven't really mentioned in your symptom list anything about your shoulders, arms, forearms, or hands.

So again, my first line of interest would be to thoroughly exam you neurologically to be sure that brain, spinal cord, and neuromuscular connections are normal. As far as the TACHYCARDIA in the AM were concerned I would think in terms of possible AUTONOMIC DYSFUNCTION or RELATIVE DEHYDRATION although...that's not going to be a great diagnosis if things actually get better as the day wears on into the afternoon. Nevertheless, there are blood tests and other sorts of maneuvers using a tilt table, or just taking multiple orthostatic BLOOD PRESSURES that could point to something wrong if they were done and found to be abnormal.

Of course, there are things such as MRI's, EMG's and NERVE CONDUCTION STUDIES, however, I wouldn't recommend doing any of those types of tests until being thoroughly examined clinically to see if any of those tests are warranted. I would also wish to look at the full conglomerate of paperwork, testing, and MEDICAL NOTES from everyone you've seen to date to see what sorts of ideas are floating around from the physicians you've seen.

My impression about the plethora of supplements is that you're going way overboard the same way that doctors sometimes have a habit of doing when they see someone who they don't quite understand just start prescribing something to "see what happens".....pretty soon, NOTHING is working but instead of adjusting the regimen other doctors just keep ADDING...until there are just a ridiculous # of drugs that the person is taking.......you've got to pull back on that kind of thing and get to the heart of a GOOD NUTRITIONAL PROGRAM.....GOOD HYDRATION, GOOD OXYGEN UTILIZATION, and GOOD SLEEP HYGIENE.

Of course, we can't forget about the HUGE contribution that your mental attitude and perspective can play and so that needs to be examined with a fine tooth comb...especially if PHYSICAL TESTS And DATA don't support the presence of an obvious ORGANIC ETIOLOGY (cause) to ALL YOUR SYMPTOMS.

So bottom line is...of all the things you've mentioned....my gestalt is to focus on the heaviness or discomfort in the legs which is PROXIMALLY based and try and make some sense out of that problem first and then, only later coming back to try and insert some of the other symptoms which don't seem quite as egregious or out front as the leg problem. I might also recommend that a true functional Basal Metabolic Rate be measured on you (aside from just looking at the thyroid and adrenal function by labwork) and see what's what both before and after heavy exercise.

I'd also try NOT TO SPEND a whole of money on more tests and other things (deep tissue massages) unless there is a real compelling point to doing such activities in the face of so much that's been done that's normal to this point. I'd get the previous tests and results from labs and medical reports collated so that someone can thoroughly review things so that they don't go REINVENTING THE WHEEL.

Then, based upon all of this information I would propose a plan of attack which would invariably include neuropsychological functioning and testing by an expert who can work closely with the neurologist to see what's what between the ear canals.....:)

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 44 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Thank you for those additional details

Detailed Answer:
I believe what needs to happen are the following:

1. Find a neurologist who can test the integrity of your central and peripheral nervous systems. That's what we are trained to do. Your example of "feeling heaviness" in the legs which worsens when you do heavy exercise...as an example....tells me that in fact, your systems are FUNCTIONING probably at peak capacity. You obviously accomplish a lot of things and PERHAPS maybe even to "excess?" So, your use of the word "weakness" needs to be standardized. When a neurologist examines you this will sort itself out.

2. A neurologist will not TYPICALLY be someone who performs detailed neuropsychological testing although we can and do do some cursory bedside testing when it comes to mental status, however, in your case my guess is that the bedside testing would come out very high functioning. What would be better would be for the neurologist to REFER to a NEUROPSYCHOLOGIST who can administer more detailed batteries of tests looking for other potential issues that could be manifesting themselves as physical symptoms. For example, you mentioned depression as being something you believe is present.....things like that. And so, I would recommend that a NEUROLOGIST REFER you to a neuropsychologist who will send his/her results and study conclusions back to the neurologist.

3. Getting records together such as lab tests, imaging studies, MEDICAL REPORTS written by the variety of doctors you've seen would be very helpful in my opinion so that the next doctor can have an idea of what's been looked at so as not to repeat things such as labs, etc.

4. I would stop doing any and all procedures, manipulations (chiropractic or otherwise), massages, and/or taking of medications or SUPPLEMENTS which have not produced the results. I know you said you take an 8 month rest from exercise.....now I am recommending that you take full leave of any and procedures and interventions which are costing you money you likely would be better SAVING for more appropriate purposes...and not throw it at things are ventures that have not helped you.

5. Pushing your body to the "limit" has not helped at this point. Therefore, backing off to a more reasonable and more low key level of maintaining fitness would be a better thing right now....In other words, stop revving the engine of the car hoping it's going to suddenly get unstuck from the mud.....that never works....Gently does it and a more level headed direction and amount at doing things usually unsticks wheels from the mud more readily....Make sense?

6. Your last statement of being "overwhelmed" with everything tells me some things which I'm not going to try and interpret fully here because I CANNOT without the other parts of the puzzle in place first....namely the FULL and complete history of what you've been through with other practitioners, the FULL and complete PHYSICAL and APPROPRIATE laboratory examination, and the NEUROPSYCHOLOGICAL TESTING.......but what I believe will HELP you sort out a lot of your physical challenges right now will be allowing your mind to change its focus to TEACHING and FAMILY.

Make sense.

You can always write back in the future with any results and/or conclusions that your next practitioner whether it be a neurologist or not and I'm happy to opine but do think about the things I've said....most importantly the focus of where your MIND should be right now relative to YOUR BODY and I believe things will be easier to sort out for both you and the doctor.

I do appreciate your kind words and wish you all the best in the New Year. You know how to get in touch with me on this network when the time is right after you've implemented things I've mentioned......MOST IMPORTANTLY in my opinion the last part of what I said about PULLING THINGS BACK and dropping things that have had no role in moving you FORWARD to improvement and resolution of your problems.

If you have found at least some of what I've said of benefit I once again would be appreciative of some positive feedback with a high 5 STAR rating (which is how we get bigger bags of peanuts on this network to sit with in front of the screen and talk to folks!) LOL.....

You may also close this consult at this point if your direction is clear and look for me again in the future at: www.bit.ly/drdariushsaghafi Of course, if you were in the XXXXXXX area running our famous marathon...or any subset of that such as the XXXXXXX Arboretum 5 K or even the XXXXXXX 10K then, you are more than welcome to stop by....we're just "down the street" from both...in a way.....

I await to hear how things are getting BETTER in the near future.

This query has utilized a total of 74 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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